City staff presented two related items affecting emergency medical services revenue: a proposed second amendment to the city’s EMS billing services agreement with Digitech EMS Billing LLC and a request to ratify the city’s participation in state Medicaid supplemental programs (PEMT and MCO), which require an initial cost share payment.

Digitech amendment: the deputy fire chief and finance director said the current billing arrangement includes a percentage collection fee plus a software/equipment charge. Staff proposed a second amendment that would remove the variable software charge and replace it with a flat $960 per month software fee, and would extend the contract for an additional three years with a remaining two‑year renewal option. Staff said Digitech has been the city’s billing vendor since around 2019 and recommended approval to ensure continuity of collections and access to the vendor’s ESO electronic patient care reporting software.

PEMT/MCO cost share: staff said the state’s PEMT and managed‑care (MCO) cost‑share program requires a municipal contribution. The city manager informed commissioners that because of an October 1 deadline he signed the agreement; staff requested commission ratification of the $260,797 cost‑share payment. Staff explained the program is a cost‑share pool: jurisdictions contribute an allocated share and later receive supplemental distributions tied to transport collections; the program supplements Medicaid payments for EMS transports and does not change billing to uninsured residents.

Why it matters: EMS transport revenues are a material city revenue stream for the fire/EMS enterprise fund; contract terms and participation in state programs affect cash flow and compliance timelines.

Commissioner questions: several commissioners asked for the original 2021 contract, the proposed amendment, performance audits or reviews for Digitech, a fiscal impact statement comparing the old and new cost structure, and verification of any sole‑source justification. The city attorney said staff will avoid presenting a sole‑source justification and will reword the item to show it is in the city’s best interest. Commissioners asked the vendor/engineer and finance staff to provide backup documents and recommended tabling the Digitech amendment until the next meeting; staff agreed to provide the requested materials and to have the city attorney prepare a memo on procurement compliance.

Ending: The commission directed staff to return with the original contract, proposed amendment, performance summary, and a fiscal impact memo; staff will reword sole‑source language and present the item again at a later meeting. The PEMT/MCO ratification remained on the consent list for action at the commission meeting; staff explained that enrollment in the program does not change the city’s policy of not pursuing collections against residents who cannot pay for transports.